In this week’s edition of the Pediheart Podcast, Dr. Pass reviews a recent article from The Journal of Heart and Lung Transplantation, entitled “Early outcomes for low-risk pediatric heart transplant recipients and steroid avoidance: A multicenter cohort study (Clinical Trials in Organ Transplantation in Children – CTOTC-04).” This landmark study assesses the impact of novel anti-rejection approaches which markedly reduce or remove steroids in the prevention of rejection. How are rejection rates affected by such an approach? Did incidences of diabetes or posttransplant lymphoproliferative disease (PTLD) differ when using this form of steroid reduced approach in the “low immunological risk” subset of patients undergoing heart transplantation?
Dr. Pass’s guest this week is the first author of this work, Dr. Jacqueline Lamour, Professor of Pediatrics of The Albert Einstein College of Medicine; and Director, Pediatric Advanced Cardiac Therapies, Children’s Hospital at Montefiore. Dr. Lamour provides her insights on this study, as well as:
• Her rationale for a biopsy-heavy means of monitoring heart transplant patients
• Thoughts as to why, for the first time, non-black race was associated with more rejection
• Implications of the time frame of this study (one year) and how biological differences might change outcomes during the follow-up study (five years)
• How the expanding base of knowledge about the immunology of transplantation makes it likely that transplant experts may one day be able to use less immune-suppressive agents and prevent rejection with comparably good outcomes, and perhaps, even fewer infectious complications ,
Each week, the Pediheart Podcast reviews the latest literature and interviews thought leaders in pediatric cardiovascular care. Tune in often to stay on top of the field.